Document Detail


Frequency, risk factors, and prognosis of prolonged delirium in elderly patients after hip fracture surgery.
MedLine Citation:
PMID:  21327416     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Delirium in elderly patients after hip fracture surgery is believed to be a transient event, although it frequently lasts for more than 4 weeks.
QUESTIONS/PURPOSES: We determined the incidence, risk factors, morbidity, and mortality of prolonged delirium in elderly patients after hip fracture surgery.
PATIENTS AND METHODS: We evaluated 232 elderly patients (older than 65 years) (232 hips) who underwent hip fracture surgery for the development and duration of delirium and categorized them into three groups; nondelirium group, transient (≤ 4 weeks) delirium group, and prolonged (> 4 weeks) delirium group. Patients underwent a global geriatric evaluation, which included postoperative complications, mortality, and functional and mental status evaluations. The three groups were compared with respect to these variables.
RESULTS: Seventy patients (30.2%) had delirium develop, and among these, 14 (20%) had prolonged delirium with a total incidence of 6%. Multivariate analysis showed preinjury dementia was a risk factor of prolonged delirium. At the final followup, five (62.5%) of the eight patients who were ambulatory outdoors in the prolonged delirium group became housebound, whereas only 18 (16.4%) of the 110 patients who were ambulatory outdoors in the nondelirium group became housebound. Survival at 40 months was 81.0% (95% confidence interval, 72.6%-89.3%) in the nondelirium group and 63.6% (95% confidence interval, 35.2%-92.1%) in the prolonged delirium group.
CONCLUSIONS: Prolonged delirium was found to be associated with a poor functional outcome and increased mortality.
LEVEL OF EVIDENCE: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Authors:
Kyung-Hag Lee; Yong-Chan Ha; Young-Kyun Lee; Hyun Kang; Kyung-Hoi Koo
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Publication Detail:
Type:  Journal Article     Date:  2011-02-15
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  469     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-02     Completed Date:  2011-09-30     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2612-20     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip / adverse effects*,  mortality
Delirium / diagnosis,  etiology*,  mortality
Female
Fracture Fixation, Internal / adverse effects*,  mortality
Hip Fractures / mortality,  surgery*
Humans
Kaplan-Meier Estimate
Logistic Models
Male
Republic of Korea
Risk Assessment
Risk Factors
Survival Rate
Time Factors
Treatment Outcome
Comments/Corrections

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